How can cannabis and cannabinoids help me? What the research says

Medical cannabis and cannabinoids in raw or dried flowers, oils, capsules, powders, edibles, and topicals may reduce pain, and some evidence shows benefit with nausea, vomiting, and sleep, but little evidence of improving treatment outcomes.

How can cannabis and cannabinoids help me? What the research says

We summarize the clinical evidence for each medical benefit here. We begin with our assessment of the strength of evidence within each category, followed by a brief summary of individual studies or reviews of several studies. In assessing the strength of evidence, we consider the study design, number of participants, and the size of the treatment effect (how much outcomes changed with treatment).

Our assessments of evidence for each medical benefit fall into one of these categories:

Strong evidence: consistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analysesa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results
Good evidence: significant effects in one large or several mid-sized and well-designed clinical studies ( randomized controlled trialsa study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects with an appropriate placebo or other strong comparison control or observational studies that control for confounds)
Modest evidence: significant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies), or several small studies aggregated into a meta-analysis
Preliminary evidence: significant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect
Weak evidence: one or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects
Insufficient evidence: preclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example)

How We Rate Therapies

Learn more about how we research and rate therapies and practices.

A brief summary of preclinical evidence is in Are you a health professional? ›

Improving treatment outcomes

Is cannabis or cannabinoids linked to improved survival? Is it linked to less cancer growth or metastasis? Does it enhance the anticancer action of other treatments or therapies? We present the evidence.

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of anticancer effects and reduced tumors

A brief summary of preclinical evidence is listed on Are you a health professional? ›

Also see evidence of worse outcomes among people treated with immunotherapy in Safety and precautions ›

“No strong clinical trial data exist to confirm the pre-clinical studies that suggest cannabinoids may have an anticancer benefit” according to a 2021 review¹Guggisberg J, Schumacher M, Gilmore G, Zylla DM. Cannabis as an anticancer agent: a review of clinical data and assessment of case reports. Cannabis and Cannabinoid Research. 2021 Aug 7.
“Limited, insufficient or absent evidence supporting improvement in cancer” in a 2018 review²Abrams DI. The therapeutic effects of cannabis and cannabinoids: an update from the National Academies of Sciences, Engineering and Medicine report. European Journal of Internal Medicine. 2018 Mar;49:7-11.
No evidence of an effect on 5-year overall survival, disease-specific survival, or metastasis-free survival among people with oropharynx squamous cell carcinoma with cannabis use compared to no use in a small observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods study³Zhang H, Xie M et al. Survival outcomes of marijuana users in p16 positive oropharynx cancer patients. Journal of Otolaryngology—Head and Neck Surgery. 2019 Sep 2;48(1):43.
Fewer circulating tumor cells and in some cases reduced tumor volume among people with cancer, mostly metastatic cancer, treated with synthetic, pharmaceutical-grade CBD and sometimes with Sativex (nabiximol) as a source of THC given intermittently (3 days on, 3 days off) for 6 months or longer; people who reverted to commercial cannabis oil had an 80% relapse rate in case reports⁴Kenyon J, Liu W, Dalgleish A. Report of objective clinical responses of cancer patients to pharmaceutical-grade synthetic cannabidiol. Anticancer Research. 2018 Oct;38(10):5831-5835./

Optimizing your body terrain

Does cannabis or cannabinoids promote an environment within your body that is less supportive of cancer development, growth, or spread? We present the evidence.

Blood sugar and insulin resistance

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of lower blood sugar levels among people with type 2 diabetes treated with THCV

Immune function

Preliminary evidence of higher rates of immunosuppression among people with advanced cancer initiating immunotherapy using cannabis

Your microbiome

Preliminary evidence of changes in the relative numbers of microbial species in the tongue and oral pharynx among people with chronic inhalation-based exposure to cannabis

Managing side effects and promoting wellness

Is cannabis or cannabinoids linked to fewer or less severe side effects or symptoms? Is it linked to less toxicity from cancer treatment? Does it support your quality of life or promote general well-being? We present the evidence.

Side effects as a whole

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on total symptom distress scores among people with advanced cancer treated with titrated CBD oil in a study

Anxiety

Insufficient evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of fewer anxiety symptoms among people with cancer using cannabis or cannabinoids

Changes in appetite

No evidence of an effect on appetite among people with cancer treated with cannabis or cannabinoids in several analyses of studies

Gastrointestinal effects

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of less chemotherapy-induced nausea and vomiting among people using cannabis or cannabinoids

Modest evidence of less vomiting among people treated with cannabinoids compared to neuroleptics (antipsychotic medication)

Modest evidence of comparable effects on nausea and vomiting among people treated with cannabinoids compared to prochlorperazine

Some studies found that pharmaceutical cannabinoids were less tolerated and less safe than placebo, as noted in Safety and precautions ›

Compared to placebo or controls: modest evidence of less chemotherapy-induced nausea and vomiting among people using cannabis or cannabinoids

Less chemotherapy-induced nausea and vomiting, but no evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on nausea alone or vomiting alone, among people treated with oral cannabis compared to placebo or other treatments in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 5 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁴Chow R, Valdez C, Chow N, et al. Oral cannabinoid for the prophylaxis of chemotherapy-induced nausea and vomiting—a systematic review and meta-analysis. Supportive Care in Cancer. 2020;28:2095-2103.
A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently toward less nausea and vomiting among people with cancer treated with cannabis or cannabinoids compared to placebo in a meta-analysis of 9 RCTs and controlled trialsa study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial¹⁵Mücke M, Carter C et al. Cannabinoide in der palliativen Versorgung: Systematische Übersicht und Metaanalyse der Wirksamkeit, Verträglichkeit und Sicherheit [Cannabinoids in palliative care: systematic review and meta-analysis of efficacy, tolerability and safety]. Schmerz. 2016 Feb;30(1):25-36. German.
Moderate quality evidence on the efficacy of cannabinoids compared to placebo for chemotherapy-induced nausea and vomiting in systematic reviews of randomized controlled trials;¹⁶Tafelski S, Häuser W, Schäfer M. Efficacy, tolerability, and safety of cannabinoids for chemotherapy-induced nausea and vomiting—a systematic review of systematic reviews. Schmerz. 2016;30:14-24. this study also found that pharmaceutical cannabinoids were less tolerated and less safe than placebo, as noted in Safety and precautions ›
Less chemotherapy-induced nausea and vomiting among people using cannabinoids compared to placebo in a systematic review of high methodological quality¹⁷Schussel V, Kenzo L, Santos A, et al. Cannabinoids for nausea and vomiting related to chemotherapy: overview of systematic reviews. Phytotherapy Research. 2018;32:567-576.
No evidence of an effect on nausea and vomiting among people with cancer treated with cannabinoids compared to placebo in a meta-analysis of 9 RCTs of low quality¹⁸Mücke M, Weier M. Systematic review and meta-analysis of cannabinoids in palliative medicine. Journal of Cachexia, Sarcopenia and Muscle. 2018 Apr;9(2):220-234.
Higher likelihood of a complete absence of vomiting, either with or without nausea, during chemotherapy treatment among people treated with cannabinoids compared to placebo in a meta-analysis of 3 RCTs of low quality¹⁹Smith LA, Azariah F, Lavender VT, Stoner NS, Bettiol S. Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy. Cochrane Database or Systematic Reviews. 2015 Nov 12;2015(11):CD009464.
Less nausea and vomiting among children and adolescents with chemotherapy-induced nausea and vomiting with cannabinoid use compared to controls or baseline in a review of 22 studies of various designs²⁰Wong SS, Wilens TE. Medical cannabinoids in children and adolescents: a systematic review. Pediatrics. 2017 Nov;140(5). pii: e20171818.
A very weak trend toward less vomiting during chemotherapy treatment among people with cancer treated with dronabinol compared to placebo in a meta-analysis of a subset of 30 RCTs²¹Machado Rocha FC, Stéfano SC, De Cássia Haiek R, Rosa Oliveira LM, Da Silveira DX. Therapeutic use of Cannabis sativa on chemotherapy-induced nausea and vomiting among cancer patients: systematic review and meta-analysis. European Journal of Cancer Care (England). 2008 Sep;17(5):431-43.
Less refractory chemotherapy-induced nausea and vomiting (absence of emesis, use of rescue medications, absence of significant nausea, and summary scores for the Functional Living Index-Emesis) among people treated with 1 cycle of 1-4 self-titrated capsules of oral THC 2.5 mg/CBD 2.5 mg (TN-TC11M) 3 times daily, from days -1 to 5 compared to placebo in a small RCT;²²Grimison P, Mersiades A, Kirby A, et al. Oral THC:CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: a randomised, placebo-controlled, phase II crossover trial. Annals of Oncology. 2020;31:1553-1560. a higher rate of adverse side effects was also seen, as noted in Safety and precautions ›

Compared to other therapies

Modest evidence of less vomiting among people treated with cannabinoids compared to neuroleptics (antipsychotic medication)

Modest evidence of comparable effects on nausea and vomiting among people treated with cannabinoids compared to prochlorperazine

Comparable chemotherapy-induced nausea and vomiting among people using cannabinoids compared to prochlorperazine in a systematic review of high methodological quality²³Schussel V, Kenzo L, Santos A, et al. Cannabinoids for nausea and vomiting related to chemotherapy: overview of systematic reviews. Phytotherapy Research. 2018;32:567-576.
Moderate quality evidence on the efficacy of cannabinoids compared to conventional antiemetics for chemotherapy-induced nausea and vomiting in systematic reviews of randomized controlled trials;²⁴Tafelski S, Häuser W, Schäfer M. Efficacy, tolerability, and safety of cannabinoids for chemotherapy-induced nausea and vomiting—a systematic review of systematic reviews. Schmerz. 2016;30:14-24. this study also found that pharmaceutical cannabinoids were less tolerated and less safe than conventional antiemetics, as noted in Safety and precautions ›
No difference in the number of people reporting nausea and vomiting during chemotherapy treatment among people treated with cannabinoids compared to prochlorperazine in a meta-analysis of 5 RCTs of low quality²⁵Smith LA, Azariah F, Lavender VT, Stoner NS, Bettiol S. Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy. Cochrane Database or Systematic Reviews. 2015 Nov 12;2015(11):CD009464.
Less vomiting during chemotherapy treatment among people with cancer treated with dronabinol compared to neuroleptics in a meta-analysis of a subset of 30 RCTs²⁶Machado Rocha FC, Stéfano SC, De Cássia Haiek R, Rosa Oliveira LM, Da Silveira DX. Therapeutic use of Cannabis sativa on chemotherapy-induced nausea and vomiting among cancer patients: systematic review and meta-analysis. European Journal of Cancer Care (England). 2008 Sep;17(5):431-43.
A weak trend toward less vomiting during chemotherapy treatment among people with cancer treated with nabilone compared to neuroleptics in a meta-analysis of a subset of 30 RCTs²⁷Machado Rocha FC, Stéfano SC, De Cássia Haiek R, Rosa Oliveira LM, Da Silveira DX. Therapeutic use of Cannabis sativa on chemotherapy-induced nausea and vomiting among cancer patients: systematic review and meta-analysis. European Journal of Cancer Care (England). 2008 Sep;17(5):431-43.
Less chemotherapy-induced nausea and vomiting among people treated with oral cannabis compared to placebo or other treatments in a meta-analysis of 5 RCTs²⁸Chow R, Valdez C, Chow N, et al. Oral cannabinoid for the prophylaxis of chemotherapy-induced nausea and vomiting—a systematic review and meta-analysis. Supportive Care in Cancer. 2020;28:2095-2103.

Neurological symptoms

Modest evidence of lower neuropathic pain scores among people with pain treated with THC/CBD or THC alone

Pain

Modest evidence of less cancer-related pain among people treated with either cannabis or some cannabinoids

Insufficient (conflicting) evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of an effect on pain among people treated with opioids when adding cannabinoids in combined analyses of studies

Quality of life and function

Modest evidence of a very small improvement in physical functioning but no evidence of an effect on quality of life among people with chronic pain or cancer treated with cannabis or cannabinoids

Sleep disruption

Insufficient evidence of better sleep quality among people with cancer or chronic pain treated with oral cannabis or cannabinoids

Symptoms not specific to cancer

Modest evidence of fewer anxiety symptoms among people with non-cancer medical conditions treated with pharmaceutical THC either with or without CBD

Good evidence of lower pain scores among people with pain treated with cannabis or cannabinoids

Modest evidence of less opioid use among people receiving opioid treatment for chronic pain also treated with medical cannabis for at least 30 days

Anxiety: modest evidence of fewer anxiety symptoms among people with non-cancer medical conditions treated with pharmaceutical THC either with or without CBD

Fewer anxiety symptoms among people with non-cancer medical conditions (primarily chronic non-cancer pain and multiple sclerosis) treated with pharmaceutical THC either with or without CBD compared to controls in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 31 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects and other clinical trials of low quality⁵⁰Black N, Stockings E, Campbell G, Tran LT, Zagic D, Hall WD, Farrell M, Degenhardt L. Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis. Lancet Psychiatry. 2019 Dec;6(12):995-1010.

Pain

Good evidence of lower pain scores among people with pain treated with cannabis or cannabinoids

Modest evidence of less opioid use among people receiving opioid treatment for chronic pain also treated with medical cannabis for at least 30 days

Moderately lower pain scores among people with pain—the majority with neuropathic pain—treated with synthetic cannabinoids exclusively THC compared to controls in a meta-analysis of 6 RCTs⁵¹McDonagh MS, Morasco BJ et al. Cannabis-based products for chronic pain: a systematic review. Annals of Internal Medicine. 2022 Jun 7.
Lower pain from physical damage (nociceptive pain) among people treated with oral standardized cannabis extract compared to controls in a meta-analysis of 25 RCTs⁵²Rabgay K, Waranuch N et al. The effects of cannabis, cannabinoids, and their administration routes on pain control efficacy and safety: a systematic review and network meta-analysis. Journal of the American Pharmacists Association. 2020 Jan-Feb;60(1):225-234.e6.
Less opioid use (greater reduction in use) among people receiving opioid treatment for chronic pain also treated with medical cannabis for at least 30 days compared to less than 30 days in a very large observational study⁵³Nguyen T, Li Y, Greene D, Stancliff S, Quackenbush N. Changes in prescribed opioid dosages among patients receiving medical cannabis for chronic pain, New York State, 2017-2019. JAMA Network Open. 2023 Jan 3;6(1):e2254573.
Conclusive or substantial evidence that cannabis or cannabinoids are effective for treating pain in adults in a systematic review of recent (at that time) medical literature⁵⁴Abrams DI. The therapeutic effects of cannabis and cannabinoids: an update from the National Academies of Sciences, Engineering and Medicine report. European Journal of Internal Medicine. 2018 Mar;49:7-11.

Reducing cancer risk

Is cannabis or cannabinoids linked to lower risks of developing cancer or of recurrence? We present the evidence.

Head, neck, and oral cancer

No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on cancer recurrence of oropharynx squamous cell carcinoma among people using cannabis in a preliminary study

No evidence of an effect on risk of head and neck squamous cell carcinoma among people using cannabis

Keep reading about cannabis and cannabinoids

See all our reviews of complementary therapies

Authors

Nancy Hepp, MS

Lead Researcher and Program Manager

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Laura Pole, RN, MSN, OCNS

Senior Clinical Consultant

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Reviewer

Teresa Martin

Integrative patient advocate

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Last update: February 20, 2023

Last full literature review: October 2021

We are grateful to integrative oncologist and CancerChoices advisor Donald Abrams, MD, for his generous sharing of research articles and commentary.

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

CancerChoices and BCCT Take: Cannabis and Head and Neck Cancer

References[+]

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53	Nguyen T, Li Y, Greene D, Stancliff S, Quackenbush N. Changes in prescribed opioid dosages among patients receiving medical cannabis for chronic pain, New York State, 2017-2019. JAMA Network Open. 2023 Jan 3;6(1):e2254573.
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Cannabis and Cannabinoids (Marijuana)

How can cannabis and cannabinoids help me? What the research says

How We Rate Therapies

Improving treatment outcomes

Optimizing your body terrain

Managing side effects and promoting wellness

Reducing cancer risk

Keep reading about cannabis and cannabinoids

Authors

Nancy Hepp, MS

Laura Pole, RN, MSN, OCNS

Reviewer

Teresa Martin

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CancerChoices and BCCT Take: Cannabis and Head and Neck Cancer